Contraceptive use among female sex workers in Mombasa County, Kenya
Wilkister, Kerebi Nyanumba
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Globally about 210 million women conceive annually, and 38% of these pregnancies are unintended. The prevalence in Kenya is over 20%, occurring mostly among poor and less educated women such as female sex workers (FSWs) and impacts negatively on the quality of life of the mother, child and family. The overall objective of this study was to determine whether knowledge of contraceptives and attitude towards contraceptives influence use of modern contraceptives by female sex workers in Mombasa County. Specific objectives were to determine the demographic and socio-economic attributes; use of modern contraceptives, and the relationship between knowledge and attitude and current use of modern contraceptives by the female sex workers in Mombasa County. Cross sectional study design employing quantitative techniques was applied. A representative sample of 357FSWs aged 15-49 years was obtained from a population of 5000 FSWs in Kisauni using snowballing technique. All relevant approvals were obtained and researcher administered questionnaires were used to collect data from consenting respondents. Data was entered into excel and analyzed in SPSS for descriptive and inferential statistics. A response rate of 100% was achieved. Majority of the FSWs (61.6%) were aged 15-30 years. Most of them (96.4%) were literate, Christian (81%) and single (56.6%) with 71.4% having 1-3 children. Further, 90.2% started sex work when aged 15-19 years. Ever use and current use of modern contraceptives was 97.8% and 94.4% respectively. Condoms (66%), injectables (36%) and Norplant (15%) were the most common contraceptive methods currently used. The most commonly mentioned contraceptives were injectables (91.3%), BTL (86.6%) and Pills (82%). Over half of the FSWs (59%) were aware of at least four contraceptive methods. The level of awareness had a significant (p=0.02) relationship with the level of education. Only 23% of all the FSWs could articulate their individual risk of pregnancy while 72.6% and 65.3% harbored myths about the coil and BTL respectively (P<O.OOI).The knowledge levels were significantly different (P<O.OOl) with majority (72.5%) having moderate knowledge. There was no relationship between knowledge levels and ever and current use of modem contraceptives. Most respondents had a positive attitude towards contraceptive use. Attitude had a significant influence on the use of dual (p=0.02; X2=9.62; OR= 2.366) and long acting methods (P<O.OOI;X2 =13.698; OR= 2.446). Future interventions should I' focus more on attitude change as opposed to knowledge and directed more to youths who are the majority in sex work and therefore most affected by unintended pregnancies. Further research is required towards formulation of a strategy on attitude change and also a similar multi-locational study to assess whether the trends in this study occur in other counties.